Objective To implore the feasibility of using single anterior approach surgery for old cervical spine subluxation. Methods From May 2004 to July 2006,16 cases of old cervical spine subluxation underwent cervical spine surgery through anterior approach at least 2 months after injury. During operation, we managed to reconstruct the cervical vertebral body alignment through a special anterior approach decompression, application of retractor instrument, titanium mesh and plate manipulation. Results Follow-ups averaged 8.5(6 to 11) months. The cervical vertebral body alignment Was obtained in all the 16 cases. The osseous fusion was assured in all cases with no instrument failure. The JOA neurological scores were improved from 13.4 preoperatively to 15.9 postoperatively. Conclusion If there is no posterior compression and the posterior structure has a fibrous fusion, the single anterior approach is good enough for the old cervical spine subluxation to maintain alignment and obtain stability, and posterior reduction is not necessary.

Objective To discuss the influence of Open resetlogs on Oracle database recovery. Methods Database backup was used to recover database before resetlogs. Before Oracle 9i, Oracle database was recovered through two steps; after Oracle10g, Oracle archived redo log by new format. Results Both methods could recover Oracle database by using backups before resetlogs. Conclusion Before Oracle9i, the recovery steps are complex, so it is suggested a consistent database backup should be made after resetlogs. By using the new archived redo log format after Oracle10g, it is easy to recover database through resetlogs.

Objective:Expression of protein TSLP and selection of full human anti-TSLP single chain Fv ( scFv).Methods:The cDNA of TSLP was amplified.The amplified target gene and the expression vector pET 101/D-TOPO were ligated , and then transformed into E.coli BL21.The protein was induced to expression by IPTG and purified and identified.The biotinylated TSLP protein was used as antigen to select of human TSLP scFv from a constructed human scFv library by phage display .Results: The size of amplified cDNA of TSLP was about 423 bp,and that of expressed protein was about 26 kD.Dot blot and Western blot results showed that the expressed protein was correct.The constructed human scFv library was enriched for three rounds using biotinylated TSLP as antigen by phage display.ELISA results showed that 35% scFvs had binding activity with TSLP.The scFvs with good binding activity were selected and identified by Western blot and sequencing.Conclusion: The full human scFvs against for TSLP were selected suc-cessfully.

Objective To study the effect of long-time carbon dioxide (CO2) pneumoperitoneum on QT dispersion (QTd) in elderly patients during Davinci robotassisted surgery.Methods Thirty elderly patients undergoing elective Davinci robot-assisted hepato-pancreato-biliary surgery with general anesthesia were enrolled in this study.Pneumoperitoneum was established at 12 mm Hg ( 1 mm Hg =0.13 3 k Pa).QTd was recorded before the induction of anesthesia; at 5,15,30,60,120,180 and 240 min after pneumoperitoneum.Results Compared with before anesthesia,mean arterial blood pressure (MAP) increased significantly at 15,30 min after pneumoperitoneum ( P＜0.05 ),and had no significant difference at 5,60,120,180,240min (P＞0.05 ).Heart rate (HR) increased significantly at 15,30 min after pneumoperitoneum (P＜0.05 ).End-tidal pressure of carbon dioxide (PETCO2) increased after pneumoperi-toneum,and had significant difference at 30,60,120,180,240 min after pneumoperitoneum (P＜0.05).In 30 patients,11 patients occurred arrhythmia including atrial extrasystole,premature ventricular beats,tachycardia.Compared with before anesthesia,QTd,corrected QTd (QTcd),QT interval,corrected QT interval (QTe) were significantly increased at 15,30,60 min after pneumoperitoneum (P＜0.05),but had on significant difference at 5,120,180,240 min after pneumoperitoneum (P＞0.05).Conclusion The effect of CO2 pneumoperitoneum on the autonomic nervous system for elderly patients might be important,as an imbalance in autonomic cardiac control might lead to serious consequences.

Objective To explore the role of compound nerve conduit, made of nerve growth factors (NGF) encapsuled by biodegradable core-shell nanofibers through coaxial electrospinning, in regeneration of injured sciatic nerves in rats. Methods The compound nerve conduits were developed from the core-shell structured biodegradable nanofibers with P(LLA-CL) as a shell and BSA/NGF or BSA as a core through coaxial electrospinning. Seventy-two Sprague-Dawley rats were randomly divided into 4 even groups. The middle segments (10 mm) of the sciatic nerve were excised and the defects were repaired with sciatic nerve autograft (group A), with P(LLA-CL) conduit (group B), with PLLA-CL conduit and one injection of NGF (group C), and with P(LLA-CL)/NGF controlled-release conduit (group D), respectively. Morphologic and functional evaluations of nerve regeneration were done by gross observation, sciatic function index, neural electrophysiological examination, resumption rates of triceps weight, histological and ultrastructural observa-tion respectively in 1, 2, 3 months after the operation. Results Three months after the operation, although partial biodegradation and small cracks could be observed, conduits remained intact in outline. Based on the functional and histological observations, nerve regeneration, nerve fibers arrangement, myelination and nerve function reconstruction in the P(LLA-CL)/NGF controlled-release conduit (group D) were similar to those in nerve autograft (group A) and significantly superior to those in groups B and C (P<0.05). Conclusion As the P(LLA-CL)/NGF-controlled release conduit has favorable mechanical properties and biocompatibility, it can effectively promote regeneration of the sciatic nerve in rats.

Objective:To develop and validate a clinical prediction model for the risk of malignant ventricular arrhythmia in patients with acute myocardial infarction (AMI) during hospitalization, and evaluate the effect of the prediction model.Methods:A retrospective study was conducted. A total of 2 649 patients with AMI admitted to cardiology department of Changzhou No.2 People's Hospital of Nanjing Medical University from December 2012 to August 2020 were enrolled. The clinical characteristics including gender, age, medical history, discharge diagnosis, vital signs during hospitalization, electrocardiogram characteristics at admission, laboratory examination indexes, interventional treatment, drug usage, malignant ventricular arrhythmias [mainly included sustained ventricular tachycardia (VT), ventricular flutter or ventricular fibrillation (VF)], and death were recorded. All patients were divided into two groups according to whether VT/VF occurred during their hospitalization. Independent risk factors for VT/VF during hospitalization were evaluated by multivariate Logistic regression analysis, and a clinical prediction model was constructed. The receiver operating characteristic curve (ROC curve) was plotted, and the area under ROC curve (AUC) was calculated to evaluate the accuracy of the prediction model.Results:A total of 2 649 eligible patients with AMI were enrolled, of whom 134 (5.06%) developed VT/VF during hospitalization. The in-hospital mortality rate in VT/VF group was significantly higher than that in non-VT/VF group (38.1% vs. 1.7%, P < 0.01). Compared with the non-VT/VF group, the patients in the VT/VF group with lower systolic blood pressure [SBP (mmHg, 1 mmHg = 0.133 kPa): 125.9±28.2 vs. 132.0±24.2], higher random blood glucose (mmol/L: 8.6±4.8 vs. 7.4±3.7), worse cardiac function [Killip heart function grade ≥ 3: 36.6% vs. 10.7%, left ventricular ejection fraction (LVEF) < 0.50: 56.7% vs. 33.6%, frequent premature ventricular contractions: 12.7% vs. 1.2%] and more hypokalemia (46.3% vs. 17.3%), with significant differences (all P < 0.05). Multivariate Logistic regression analysis showed that Killip classification of cardiac function ≥ 3 [odds ratio ( OR) = 3.540, 95% confidence interval (95% CI) was 2.336-5.363], random blood glucose > 11.1 mmol/L ( OR = 1.841, 95% CI was 1.171-2.893), LVEF < 0.50 ( OR = 0.546, 95% CI was 0.374-0.797), frequent premature ventricular contractions ( OR = 12.361, 95% CI was 6.077-25.144), potassium < 3.5 mmol/L ( OR = 4.268, 95% CI was 2.910-6.259), SBP < 90 mmHg ( OR = 0.299, 95% CI was 0.150-0.597) and creatinine (Cr) > 100 μmol/L ( OR = 2.498, 95% CI was 1.170-5.334) were independent risk factors for VT/VF in patients with AMI (all P < 0.05). The clinical prediction model of VT/VF risk was constructed based on the variables selected by multivariate regression analysis. The ROC curve analysis showed that the AUC of the model in predicting VT/VF was 0.779 (95% CI was 0.735-0.823, P < 0.001); the optimal cut-off value of the model was 17, the sensitivity was 76.1%, the specificity was 67.3%. Conclusions:The incidence of VT/VF during hospitalization of AMI patients significantly increases the risk of in-hospital death. The independent risk factors of VT/VF are Killip grade ≥ 3, random blood glucose > 11.1 mmol/L, LVEF < 0.50, frequent ventricular premature beats, potassium < 3.5 mmol/L, SBP < 90 mmHg and Cr > 100 μmol/L. The newly constructed clinical prediction model has certain predictive value for the occurrence risk of VT/VF.

Objective:To investigate the lipid-lowering effect and antioxidant activity of polysaccharide from Schisandra Chinensis (SCP)in the rats with non-alcoholic fatty liver disease (NAFLD)induced by high-fat diet,and to provide a theoretical basis for the development and utilization of Schisandra Chinensis.Methods: A total of 32 male Wistar rats were selected.Sixteen from the 32 rats were randomly selected and divided into normal control group (intragastrical administration of water,combined with normal diet,n = 8)and SCP group (intragastrical administration of 50 mg·kg-1 SCP,combined with normal diet,n=8).The remaining 16 rats were fed with high-fat diet for 4 weeks and the confirmed NAFLD rat models were set up.A total of 16 NAFLD rats were randomly divided into NAFLD group (intragastrical administration of water, combined with high-fat diet,n = 8 ) and NAFLD+SCP group (intragastrical administration of 50 mg·kg-1 SCP,combined with high-fat diet,n=8).After treated for 12 weeks,the body weights of all the rats were weighed and the liver index was calculated.The levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),alanine aminotransferase (ALT)and aspartate aminotransferase (AST)in the serum of all the rats were determined.The levels of TC and TG in liver tissue of the rats were measured by enzymatic method. The malondialdehyde (MDA)levels and superoxide dismutase (SOD)activities in serum and liver tissue and the glutathione (GSH)levels in liver tissue of the rats were analyzed by TBA,xanthinoxidase and microscale enzyme methods,respectively. HE staining was used to observe the pathomorphology of liver tissue of the rats. Results:Compared with normal control group,the liver index of the rats in NAFLD group was increased (P <0.01);the levels of TC,TG,LDL-C,ALT and AST in serum of the rats were increased (P <0.01),the levels of TC and TG in liver tissue of the rats were increased (P <0.01),the MDA level was increased (P <0.01)and the SOD activity was decreased (P <0.01),and the GSH levels in liver tissue and serum were decreased (P <0.01). Compared with NAFLD group,the body weight and liver index,serum levels of TC,TG,LDL-C ,ALT and AST of the rats in NAFLD + SCP group were decreased (P < 0.05 ),the levels of TC and TG in liver tissue were decreased (P <0.01),the MDA level was decreased (P <0.01),the SOD activities in serum and liver tissue were increased (P < 0.01),and the level of GSH in liver tissue was increased (P < 0.01).The HE staining results showed that the structure of hepatic lobules of the rats in NAFLD group was disordered and showed significant hepatic steatosis,and the hepatic steatosis in hepatic lobules of the rats in NAFLD+SCP group was significantly reduced.Conclusion:SCP has a regulation effect in the NAFLD rats induced by high-fat diet,and its mechanism may be related to the anti-oxidative stress.

Objective To study the efficacy of the deroofing-fixation operation for postoperative recurrent simple hepatic cysts (RSHC).Methods 21 patients who developed postoperative RSHC underwent the deroofing-fixation operation at the First Affiliated Hospital,Henan University of Science & Technology from August 2012 to August 2016.The data were analyzed retrospectively.Results The recurrent sites varied and included S6,7 (n=9),S7 (n=5),S8 (n=3) and S7,8 (n=4).The first operations for all these patients were either laparoscopic fenestration or windowing decompression.The recurrence time ranged from 4 to 13 months (average 6 months) after the first operation.All these patients were reoperated using the deroofing-fixation method,i.e.taparotomy,cyst deroofing and cyst edge fixation to the right hepatorenal ligament (n =9),or to the hepatic falciform ligament (n =12).All these patients were followed up for 11 to 60 months after the reoperation,and no recurrence was found.Conclusion The deroofing-fixation is an efficacious operation for post-operative RSHC.

Objective:To investigate the effect of preoperative hemoglobin (Hb) level on the risk of developing acute kidney injury (AKI) after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Methods:A retrospective study was conducted. The hospitalized patients diagnosed with AMI who underwent PCI from May 2015 to May 2020 in the department of cardiology in the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University were enrolled. According to the serum creatinine (SCr) level before and after interventional therapy, the patients were divided into an AKI group and a non-AKI group. The difference in patients' Hb levels between the AKI and non-AKI groups was compared. Univariate and multivariate Logistic regression analyses were used to analyze the effects of Hb levels on the risk of AKI after interventional therapy in patients with AMI. Kaplan-Meier survival curve was used to evaluate the effects of Hb levels on patients with AMI in all-cause death in the hospital.Results:A total of 922 AMI patients were enrolled in this study, of which 165 patients (17.9%) developed AKI. Compared with the non-AKI group, female patients in the AKI group had a higher proportion [35.8% (59/165) vs. 26.9% (204/757)], older (age: 69.78±14.56 vs. 66.61±13.44), with a lower rate of smoking [42.4% (70/165) vs. 51.7% (391/757)] and a higher prevalence of hypertension [73.3% (121/165) vs. 63.5% (481/757)], however, the patients in AKI group also had a worse cardiac function [the proportion of Killip grade 3 or above was higher: 33.9% (56/165) vs. 13.9% (105/757)], lower Hb level (g/L: 127.61±22.18 vs. 132.79±19.45), and there were less patients using angiotensin converting enzyme inhibitor/angiotensin Ⅱreceptor blocker [ACEI/ARB, 60.0% (99/165) vs. 74.5% (564/757)] and more patients using diuretics [24.8% (41/165) vs. 17.7% (134/757)] in AKI group, the differences were statistically significant (all P < 0.05). Compared with non-AKI group, patients in AKI group had a longer operation time [operation time > 60 minutes: 4.2% (7/165) vs. 1.5% (11/757)] and received more contrast media during the operative procedure [contrast media > 100 mL: 16.4% (27/165) vs. 3.6% (27/757)], the individuals had a higher rate of intra-operative hypotension [16.4% (27/165) vs. 8.2% (62/757)], and more patients were implanted more than 2 stents [8.5% (14/165) vs. 3.6% (27/757), all P < 0.05]. Univariate Logistic regression analysis suggested that each 1 g/L increase in preoperative Hb level was associated with a 1.2% decrease in the risk of postoperative AKI [odds ratio ( OR) = 0.988, 95% confidence interval (95% CI) was 0.980-0.996, P = 0.003]. Meanwhile, for every 1 standard deviation increase in preoperative Hb level, the risk of postoperative AKI decreased by 22.1% ( OR = 0.779, 95% CI was 0.661-0.918, P = 0.003). The patients were divided into low, medium and high concentration groups according to Hb levels (Hb levels were < 110 g/L, 110-150 g/L, ≥ 150 g/L, respectively), and multivariate Logistic regression analysis showed that the risk of AKI was significantly reduced in the high concentration group compared with that in the low concentration group ( OR = 0.463, 95% CI was 0.241-0.888, P = 0.020). The Kaplan-Meier survival curve analysis indicated that the short term survival after coronary intervention in AMI patients with low Hb concentration was significantly lower than that in patients with medium and high Hb concentration (Log-Rank: χ2= 23.215, P < 0.001). Conclusions:Preoperative lower Hb level is an independent risk factor for postoperative AKI in AMI patients. AMI patients with lower Hb levels have an increased risk of all-cause mortality within 1 month after AMI.

COVID-19, an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread throughout the world. China has achieved rapid containment of this highly infectious disease following the principles of early detection, early quarantine and early treatment with integrated traditional Chinese and Western medicine. The inclusion of traditional Chinese medicine (TCM) in the Chinese protocol is based on its successful historic experience in fighting against pestilence. Current findings have shown that the Chinese medicine can reduce the incidence of severe or critical events, improve clinical recovery and help alleviate symptoms such as cough or fever. To date there are over 133 ongoing registered clinical studies on TCM/integrated traditional Chinese and Western medicine. The three Chinese patent medicines (/ (Forsythiae and Honeysuckle Flower Pestilence-Clearing Granules/Capsules), (Honeysuckle Flower Cold-Relieving Granules) and (Stasis-Resolving & Toxin-Removing) were officially approved by the National Medical Products Administration to list COVID-19 as an additional indication. The pharmacological studies have suggested that Chinese medicine is effective for COVID-19 probably through its host-directed regulation and certain antiviral effects.